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November 1971

Granulomatous SclerouveitisRegression of Ocular Lesions With Cyclophosphamide and Prednisone

Author Affiliations

Bethesda, Md; Washington, DC; Charleston, WVa
From the Clinical Branch, National Eye Institute, National Institutes of Health, Department of Health, Education, and Welfare, Bethesda, Md (Dr. Brubaker); the Registry of Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington, DC (Dr. Font); and the Charleston Eye and Ear Infirmary, Charleston, WVa (Dr. Shepherd).

Arch Ophthalmol. 1971;86(5):517-524. doi:10.1001/archopht.1971.01000010519006

The patient had necrotizing scleritis which blinded his left eye and required enucleation. Histopathologic examination showed a necrotizing granulomatous sclerouveitis with multiple abscesses. He also suffered from frontal sinusitis with necrosis of the nasal septum and multiple skin ulcers on face, trunk, and lower extremities. Chest roentgenograms revealed numerous "cysts" in both lungs. Approximately 2½ years after enucleation, he developed painful scleritis in his right eye. Whereas he had failed to respond to steroid therapy alone, combination systemic therapy with prednisone and cyclophosphamide was followed by rapid healing of the sclera and the skin. This case most likely represents a limited form of Wegener's granulomatosis.